Advocates for a comprehensive health care overhaul "hoped to get a major bill during the [Obama] administration's first 100 days," but "it looks like it will take longer, and some observers fear that a historic opportunity could be missed," the Boston Globe reports. According to the Globe, the current recession, "which some say highlighted the burden of rising health care costs on businesses," has gotten worse. As a result, the economic stimulus bill and "financial bailouts are devouring the fledgling administration's political energy and kicking up considerable partisanship in Congress," according to the Globe. In addition, the Globe reports that there is some disagreement among lawmakers. House Majority Whip James Clyburn (D-S.C.) recently said that he did not expect a health care overhaul bill to pass this year, while a spokesperson for House Speaker Nancy Pelosi (D-Calif.) this week said that Pelosi expects "a major step" forward on health care reform in 2009.

Senate Democrats taking the lead in drafting and passing comprehensive health care legislation do not believe prospects for such an overhaul have dimmed significantly, according to the Globe. Senate Finance Committee Chair Max Baucus (D-Mont.) -- who in November 2008 released a "policy road map" for health care reform legislation -- said, "The cost of not doing something on health reform is much greater than the cost of taking on health reform." Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.), whose aides are preparing an overhaul bill they hope will be ready early this year, in an e-mailed statement said, "We are moving swiftly and deliberately to pass much needed health care reform. The president is committed to it and so am I."

Continued Optimism Among Advocates
The Globe reports that many advocates still believe the outlook for an overhaul is "better than it has been in a generation." Advocates note that business groups are pressing for major change, insurers have "indicated some willingness to make concessions," and unions and labor groups have "set aside millions to wage a ground campaign for a bill," according to the Globe. In addition, many advocates also see the economic stimulus package as a "first installment on a health care overhaul" because it will invest billions of dollars in technological infrastructure that could "support the health system of the future," the Globe reports (Wangsness, Boston Globe, 1/28).

Leavitt
Former HHS Secretary Mike Leavitt on Monday in a discussion with the editorial board of the Salt Lake City Deseret News spoke about the potential for comprehensive health care reform. Leavitt said a major problem with the U.S. health care system is that 16.5% of the gross national product is spent on health care that "rewards based on procedures, successful or not, and for treating sickness rather than keeping people well." According to Leavitt, the system is a web of independent "silos" that is very specialized and expensive. He said, "The solution isn't to continue to keep doing what we did in the past," adding, "The role of government needs to be worked out. Is it to own the system or organize the system?"

Leavitt believes comprehensive reform could happen in one of three ways: incremental changes, beginning with expanding children's health coverage and broadening Medicare; a major change to the entire system, with specific details determined later; or a major change to the system, carefully implemented, according to the Deseret News. Leavitt said, "Health care is a big part of the stimulus -- $100 billion -- and a lot of it is for improving health care information technology, which is wonderful," but the "big question is if this will be a pay-as-you-go effort. If they stick to a pay-go principle, the changes are more likely to be incremental."

Leavitt added that he believes that U.S. residents using a home computer eventually will be able to look up the cost, outcome and quality of medications, procedures and physicians (Thalman, Salt Lake City Deseret News, 1/27).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.